It was the morning after I'd given birth to my first child. My adrenaline had worn off, I got a few hours of sleep, and I actually felt relaxed. My brand new baby began to stir so I quickly ceased the opportunity to practice breastfeeding. With my newborn on my chest, I fumbled around with her latch, half preparing for piercing nipple pain. A few minutes in, I felt like the coast was clear.
That's when it hit me. A burning wave of pain. I knew it wasn't breastfeeding related — it seemed to start from my stomach and reverberate through my entire body. I felt my body temperature rise, and I quickly began to panic.
I pushed the nurse's call button and white-knuckled the hospital bed rails, trying to breathe through the fire brewing in my abdomen.
"Take the baby!" I shouted to my mom, whose face relayed grave concern. I pushed the nurse's call button and white-knuckled the hospital bed rails, trying to breathe through the raging fire brewing in my abdomen. By the time the nurse got there, the pain had subsided.
When I described what happened, the nurse replied: "Oh that's just your uterus shrinking. Totally normal."
My mom, infinitely helpful, added, "Oh, I remember that now!"
Turns out, new moms undergo postpartum uterine contractions. Yes, contractions. You know, those things you thought you were done having.
I had no idea, and perhaps the reason no one thought to warn me (thanks, Mom!) is that because for most first-time moms, the discomfort is on par with menstrual cramps. Either my pain tolerance was abysmal or I was the exception to the rule because my postbirth contractions were worse than the Pitocin-fueled ones I endured before begging to get an epidural.
Fast-forward two-ish years, and I was back in a hospital bed having just delivered my second baby — sans drugs. I felt pretty badass about what just transpired and very prepared for those coming-soon contractions.
But, oh my, I was not prepared. Now, listen here: postpartum uterine contractions get worse with every birth. A lot worse. Like, "mack truck rolling over my abdomen and then gunning it in reverse" worse.
Because, yet again, no one warned me about this fun postdelivery nuance with the level of specificity warranted, I will explain in useful detail what one should expect. It's the least I can do for someone who's just birthed a human and doesn't need any more surprises (aside from the thousands of millions of surprises that having kids provides).
What Are Postpartum Contractions?
They're postpartum uterine contractions, and they're often called "afterpains." You'll probably call them "&$@#%!"
What Causes Postpartum Contractions?
Imagine your uterus is a balloon. The average woman's uterus is generally three to four inches long. Throughout pregnancy, it expands like a balloon. By 40 weeks gestation, your uterus is roughly 38 inches long and reaches almost as high as your rib cage. After you birth that precious, totally-worth-all-this baby (and placenta!), it's time for the watermelon-size balloon-uterus to deflate. The uterine contractions signify just that: your uterus contracting.
How Long Do Postpartum Contractions Last?
The cramping will be most intense for the first day or two after giving birth, but it should taper off by the third day. This, however, doesn't mean your uterus is back to default settings — it can take six weeks or longer to return to "normal" size and shape. (Fun fact: like many things, it won't ever be as small as it originally was . . .)
How Long Does Each Contraction Last?
The contractions vary in frequency but are generally not persistent. Thankfully, they don't last long. Similar to labor contractions, they tend to come and go within a minute.
When Do Postpartum Contractions Happen?
They tend to manifest right when you are struggling through that highly stressful, hiiiighly painful new task of breastfeeding your hours-old baby. Perfect timing, right? Other similar types of stimulation like skin-to-skin contact can spur them, too. The reason these bonding moments tend to bring on contractions — or at least make them more intense — is that your baby triggers the release of the hormone oxytocin, which sets things in motion.
Does That Mean I Should Wait to Breastfeed?
No! In fact, it's actually a benefit to your uterus to nurse because the cramps brought on by breastfeeding help your uterus shrink more quickly, which reduces your risk of blood loss and anemia.
Why Is My Nurse Manhandling My Stomach?
She comes in peace . . . sort of. It doesn't happen across the board, but many nurses will come along to massage (not a Zen Swedish-style massage, but a fists-clenched, kneading-your-loose-skin-like-it's-bread massage) your stomach near the top of your uterus to help it contract. And to keep you from, you know, hemorrhaging.
What Can I Do For the Pain?
Ibuprofen should handle mild cases, but talk to your doctor about additional medication to minimize the discomfort. If you want to avoid meds, drink plenty of fluids, but be sure to pee often. A full bladder makes it harder for the uterus to contract completely.
Why Do They Get Worse With Every Pregnancy?
They're typically mild for first-time moms. In fact, many women don't feel them at all (must be nice!). Unfortunately, they can be extremely uncomfortable following a second delivery. They only get worse with successive births because, unlike new moms who tend to have better uterine muscle tone, uteruses of seasoned mamas aren't as able to contract and then stay contracted. Instead, they relax and contract intermittently. Ugh.
So Does This Mean I'll Get a Flat Stomach?
Ha. Haha. HA!
Now, don't say nobody warned you.